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Medical Management Guidelines for Hydrogen Chloride

Synonyms for an aqueous solution of hydrogen chloride include chlorohydric acid, hydrochloric acid, and muriatic acid.

Persons exposed only to hydrogen chloride gas do not pose
significant risks of secondary contamination. Persons whose
clothing or skin is contaminated with hydrochloric acid
can cause secondary contamination by direct contact or through
off-gassing vapor.

Hydrogen chloride is a colorless, corrosive, nonflammable
gas that fumes in air. It has a characteristic pungent odor.
It is heavier than air and may accumulate in low-lying areas.

Hydrogen chloride is not absorbed through the skin, but
when hydrogen chloride gas comes in contact with moisture,
it forms hydrochloric acid, which is corrosive and can cause
irritation and burns.

General Information

Description

At room temperature, hydrogen chloride
is a colorless to slightly yellow gas with a pungent odor.
On exposure to air, the gas forms dense white vapors due to
condensation with atmospheric moisture. The vapor is corrosive,
and air concentrations above 5 ppm can cause irritation.

Hydrogen chloride is available commercially
as an anhydrous gas or as aqueous solutions (hydrochloric
acid). Commercial concentrated hydrochloric acid contains
36% to 38% hydrogen chloride in water. Aqueous solutions generally
are colorless but may be yellow due to traces of iron, chlorine,
and organic impurities.

Routes of Exposure

Inhalation

Inhalation is an important route of exposure
to hydrogen chloride. Its odor and highly irritating properties
generally provide adequate warning for acute, high-level exposures.
However, only 50% of exposed persons can perceive hydrogen
chloride's odor at the OSHA permissible exposure limit (5
ppm), and odor may not provide adequate warning in the
workplace. Hydrogen chloride vapor is heavier than air
and may cause asphyxiation in enclosed, poorly ventilated,
or low-lying areas.

Children exposed to the same levels of
hydrogen chloride as adults may receive larger dose because
they have greater lung surface area:body weight ratios and
increased minute volumes:weight ratios. In addition, they
may be exposed to higher levels than adults in the same location
because of their short stature and the higher levels of hydrogen
chloride found nearer to the ground.

Skin/Eye Contact

Hydrogen chloride is not absorbed through
the skin. Direct contact with aqueous solutions of hydrogen
chloride or with concentrated vapor can cause severe chemical
burns.

Children are more vulnerable to toxicants
affecting the skin because of their relatively larger surface
area:body weight ratio.

Ingestion

Sources/Uses

Hydrogen chloride is produced commercially
by any of the following reactions: heated hydrogen gas with
calcium chloride, sulfuric acid with sodium chloride, sodium
chloride with sulfur dioxide and steam, and hydrogen burned
in chlorine. Hydrogen chloride can be formed during the combustion
of many plastics. Hydrochloric acid (muriatic acid) is a component
of commercial chemicals used to clean and disinfect swimming
pools.

Hydrogen chloride is used for cleaning,
pickling, and electroplating metals; in refining mineral ores;
in petroleum well extraction; in leather tanning; and in the
refining of fats, soaps, and edible oils. It is also used
in producing polymers and plastics, rubber, fertilizers, dyes,
dyestuffs, and pigments.

Standards and Guidelines

OSHA PEL (permissible exposure limit)
= 5 ppm (ceiling)

NIOSH IDLH (immediately dangerous to
life or health) = 50 ppm

AIHA ERPG-2 (emergency response planning
guideline) (maximum airborne concentration below which it
is believed that nearly all individuals could be exposed for
up to 1 hour without experiencing or developing irreversible
or other serious health effects or symptoms which could impair
an individual's ability to take protective action) = 20 ppm

Incompatibilities

Health Effects

Concentrated hydrogen chloride can be corrosive to the
skin, eyes, nose, mucous membranes, and respiratory and
gastrointestinal tracts.

Inhalation of hydrogen chloride can lead to pulmonary
edema. Ingestion can cause severe injury to the mouth, throat,
esophagus, and stomach.

Other effects of exposure include shock, circulatory collapse
metabolic acidosis, and respiratory depression.

Acute Exposure

Hydrogen chloride is a strong mineral
acid; its corrosive and irritant properties are the primary
concern in both acute and chronic exposures.

Children do not always respond to chemicals
in the same way that adults do. Different protocols for managing
their care may be needed.

Respiratory

Hydrogen chloride gas is intensely irritating
to the mucous membranes of the nose, throat, and respiratory
tract. Brief exposure to 35 ppm causes throat irritation,
and levels of 50 to 100 ppm are barely tolerable for 1 hour.
The greatest impact is on the upper respiratory tract; exposure
to high concentrations can rapidly lead to swelling and spasm
of the throat and suffocation.

Most seriously exposed persons have immediate
onset of rapid breathing, blue coloring of the skin, and narrowing
of the bronchioles. Patients who have massive exposures may
develop an accumulation of fluid in the lungs.

Exposure to hydrogen chloride can lead
to Reactive Airway Dysfunction Syndrome (RADS), a chemically-
or irritant-induced type of asthma.

Children may be more vulnerable to corrosive
agents than adults because of the relatively smaller diameter
of their airways. Children may also be more vulnerable to
gas exposure because of increased minute ventilation per kg
and failure to evacuate an area promptly when exposed.

Metabolic

A rare and unusual complication of ingestion
of high levels of hydrogen chloride is an increase in the
concentration of chloride ions in the blood, causing an acid-base
imbalance.

Because of their higher metabolic rates, children may be more
vulnerable to toxicants interfering with basic metabolism.

Dermal

Deep burns of the skin and mucous membranes
are caused by contact with concentrated hydrochloric acid
or hydrogen chloride gas; disfiguring scars may result. Contact
with less concentrated acid or with vapor or mist can cause
redness of the skin and mild inflammation.

Because of their relatively larger surface
area:body weight ratio, children are more vulnerable to toxicants
affecting the skin.

Ocular

Exposure of the eyes to concentrated
hydrogen chloride vapor or hydrochloric acid can cause corneal
cell death, cataracts, and glaucoma. Exposure to dilute solutions
can cause stinging pain and injuries such as ulcers of the
eye surface.

Gastrointestinal

Ingestion of concentrated hydrochloric
acid can also cause severe corrosive injury to the mouth,
throat esophagus, and stomach, with bleeding, perforation,
scarring, or stricture formation as potential sequelae.

Hepatic

Liver damage and ischemia may be observed.

Renal

Renal failure and nephritis may occur.

Cardiovascular

Ingestion of concentrated hydrochloric
acid or massive skin exposure to either hydrochloric acid
or hydrogen chloride gas may cause low blood pressure as a
result of gastrointestinal bleeding or fluid displacement.
After acute exposure, pulmonary function generally returns
to baseline in 7 to 14 days.

Potential Sequelae

Patients who have ingested hydrochloric
acid may experience scarring of the esophagus or stomach,
which can cause narrowing, difficulty swallowing, or gastric
outlet obstruction.

Chronic Exposure

Chronic or prolonged exposure to hydrogen
chloride gas (above the OSHA PEL) or to mist has been associated
with changes in pulmonary function, chronic inflammation of
the bronchi, nasal ulceration, and symptoms resembling acute
viral infection of the upper respiratory tract as well as
inflammation of the skin, discoloration and erosion of dental
enamel, and inflammation of the eye membrane. Chlorosis may occur with prolonged exposure.

Carcinogenicity

Hydrogen chloride has not been classified
for carcinogenic effects.

Reproductive and Developmental Effects

Some reproductive hazards of hydrogen
chloride to humans are unknown. Few studies have been directed
at reproductive effects in experimental animals exposed to
hydrogen chloride. No data were located pertaining to maternal
transfer of hydrogen chloride through the placenta or in breast
milk Hydrogen chloride is not included in Reproductive
and Developmental Toxicants, a 1991 report published by
the U.S. General Accounting Office (GAO) that lists 30 chemicals
of concern because of widely acknowledged reproductive and
developmental consequences. Fetotoxicity, developmental abnormalities, and possible resistance to hydrogen chloride by inhalation during pregnancy have been noted. No data about possible male reproductive effects is available.

Prehospital Management

Victims exposed only to hydrogen chloride gas and whose
skin and clothing appear dry do not pose risks of secondary
contamination to rescuers. However, victims exposed to hydrochloric
acid or hydrogen chloride whose clothing or skin is moist
or wet can secondarily contaminate response personnel by
direct contact or through off-gassing vapor.

High concentrations of hydrogen chloride can cause corrosive
injury to all exposed body tissues. When inhaled, it can
result in upper respiratory tract irritation, leading to
laryngeal edema, laryngeal spasm, and asphyxia. Concentrated
hydrochloric acid causes similar corrosive injury to the
skin and, if ingested, can cause severe corrosive injury
to the mouth, throat, esophagus, and stomach.

There is no antidote for hydrogen chloride poisoning.
Treatment consists of support of respiratory and cardiovascular
functions.

Hot Zone

Rescuers should be trained and appropriately
attired before entering the Hot Zone. If the proper equipment
is not available, or if rescuers have not been trained in
its use, assistance should be obtained from a local or regional
HAZMAT team or other properly equipped response organization.

Rescuer Protection

Hydrogen chloride gas is a severe respiratory-tract
and skin irritant that forms a strong acid (hydrochloric acid)
on contact with water.

ABC Reminders

Quickly access for a patent airway, ensure
adequate respiration and pulse. If trauma is suspected, maintain
cervical immobilization manually and apply a cervical collar
and a backboard when feasible.

Victim Removal

If victims can walk, lead them out of
the Hot Zone to the Decontamination Zone. Victims who are
unable to walk may be removed on backboards or gurneys; if
these are not available, carefully carry or drag victims to
safety.

Consider appropriate management of chemically
contaminated children, such as measures to reduce separation
anxiety if a child is separated from a parent or other adult.

Decontamination Zone

Victims exposed only to hydrogen chloride
gas who have no skin or eye irritation do not need decontamination;
they may be transferred immediately to the Support Zone. All
others require decontamination as described below.

Rescuer Protection

If exposure levels are determined to
be safe, decontamination may be conducted by personnel wearing
a lower level of protection than that worn in the Hot Zone
(described above).

ABC Reminders

Quickly access for a patent airway, ensure
adequate respiration and pulse. Stabilize the cervical spine
with a collar and a backboard if trauma is suspected. Administer
supplemental oxygen as required. Assist ventilation with a
bag-valve-mask device if necessary.

Basic Decontamination

Victims who are able may assist with
their own decontamination. Remove contaminated clothing while
flushing exposed skin and hair with water for 3 to 5 minutes,
wash thoroughly with soap and water. Use caution to avoid
hypothermia when decontaminating children or the elderly.
Use blankets or warmers when appropriate. Double-bag contaminated
clothing and personal belongings.

Flush exposed or irritated eyes with
tepid plain water or saline for 15 minutes. Eye irrigation
should be carried out simultaneously with other basic care
and transport. Remove contact lenses if easily removable without
additional trauma to the eye.

In cases of ingestion, do not induce
emesis. Do not administer activated charcoal or attempt to
neutralize stomach contents. Victims who are conscious
and able to swallow should be given 4 to 8 ounces of water
or milk. (Children's dose is 2 to 4 ounces.)

Consider appropriate management of chemically
contaminated children, such as measures to reduce separation
anxiety if a child is separated from a parent or other adult.
If possible, seek assistance from a child separation expert.

Transfer to Support Zone

As soon as basic decontamination is complete,
move the victim to the Support Zone.

Support Zone

Be certain that victims have been decontaminated
properly (see Decontamination Zone above). Victims
who have undergone decontamination or who have been exposed
only to gas and who have no symptoms of skin or eye irritation
pose no serious risk of secondary contamination. In such cases,
Support Zone personnel require no specialized protective gear.

ABC Reminders

Quickly access for a patent airway. If
trauma is suspected, maintain cervical immobilization manually
and apply a cervical collar and a backboard when feasible.
Ensure adequate respiration and pulse. Administer supplemental
oxygen as required and establish intravenous access if necessary.
Place on a cardiac monitor.

Additional Decontamination

Continue irrigating exposed skin and
eyes, as appropriate.

In cases of ingestion, do not induce
emesis. Do not administer activated charcoal or attempt to
neutralize stomach contents. Adult victims who are conscious
and able to swallow should be given 4 to 8 ounces of water
or milk, if it has not been given previously, to flush residual
acid from the esophagus and to dilute stomach contents. Children
should receive half of the adult dose.

Advanced Treatment

In cases of respiratory compromise secure
airway and respiration via endotracheal intubation. If not
possible, perform cricothyroidotomy if equipped and trained
to do so.

Treat patients who have bronchospasm
with aerosolized bronchodilators. The use of bronchial sensitizing
agents in situations of multiple chemical exposures may pose
additional risks. Consider the health of the myocardium before
choosing which type of bronchodilator should be administered.
Cardiac sensitizing agents may be appropriate; however, the
use of cardiac sensitizing agents after exposure to certain
chemicals may pose enhanced risk of cardiac arrhythmias (especially
in the elderly). Sympathomimetic bronchodilators generally
will reverse bronchospasm in patients exposed to hydrogen
chloride.

Patients who are comatose, hypotensive,
or are having seizures or cardiac arrhythmias should be treated
according to advanced life support (ALS) protocols.

Transport to Medical Facility

Only decontaminated patients or patients
not requiring decontamination should be transported to a medical
facility. "Body bags" are not recommended.

Report to the base station and the receiving
medical facility the condition of the patient, treatment given,
and estimated time of arrival at the medical facility.

If hydrochloric acid has been ingested,
prepare the ambulance in case the victim vomits toxic material.
Have ready several towels and open plastic bags to quickly
clean up and isolate vomitus.

Multi-Casualty Triage

Consult with the base station physician
or the regional poison control center for advice regarding
triage of multiple victims.

Patients with evidence of significant
exposure such as skin or eye irritation, pain, or breathing
difficulties should be transported to a medical facility for
evaluation. Others may be discharged from the scene after
their names, addresses, and telephone numbers are recorded.
Those discharged should be advised to seek medical care promptly
if symptoms develop (see Patient Information Sheet
below).

Emergency Department Management

Patients exposed only to hydrogen chloride gas whose clothing
and skin are dry do not pose a risk of secondary contamination.
Hospital personnel can be secondarily contaminated by patients
exposed to hydrochloric acid either by direct skin contact
or through inhalation of vapor off-gassing from heavily
soaked clothing or skin. Patients do not pose contamination
risks after contaminated clothing is removed and the skin
is washed.

High concentrations of hydrogen chloride causes corrosive
injury to all exposed body tissues. When inhaled, it can
result in upper respiratory tract irritation, leading to
laryngeal edema, laryngeal spasm, and asphyxia. Concentrated
hydrochloric acid causes similar corrosive injuries to exposed
tissues and, if ingested, can cause severe corrosive injury
to the mouth, throat, esophagus, and stomach.

There is no antidote for hydrogen chloride poisoning.
Treatment consists of support of respiratory and cardiovascular
functions.

Decontamination Area

Previously decontaminated patients and
patients exposed only to hydrogen chloride gas who have no
skin or eye irritation may be transferred immediately to the
Critical Care Area. Others require decontamination as described
below.

Hospital personnel should don rubber
gloves, rubber aprons, and eye protection before treating
patients who are wet with hydrochloric acid.

Be aware that use of protective equipment
by the provider may cause fear in children, resulting in decreased
compliance with further management efforts.

Because of their relatively larger surface
area:body weight ratio, children are more vulnerable to toxicants
affecting the skin. Also, emergency room personnel should
examine children's mouths because of the frequency of hand-to-mouth
activity among children.

ABC Reminders

Evaluate and support airway, breathing,
and circulation. Children may be more vulnerable to corrosive
agents than adults because of the smaller diameter of their
airways. In cases of respiratory compromise secure airway
and respiration via endotracheal intubation. If not possible,
surgically create an airway.

Treat patients who have bronchospasm
with aerosolized bronchodilators. The use of bronchial sensitizing
agents in situations of multiple chemical exposures may pose
additional risks. Consider the health of the myocardium before
choosing which type of bronchodilator should be administered.
Cardiac sensitizing agents may be appropriate; however, the
use of cardiac sensitizing agents after exposure to certain
chemicals may pose enhanced risk of cardiac arrhythmias (especially
in the elderly). Hydrogen chloride poisoning is not known
to pose additional risk during the use of bronchial or cardiac
sensitizing agents. Sympathomimetic bronchodilators generally
will reverse bronchospasm in patients exposed to hydrogen
chloride.

Patients who are comatose, hypotensive,
or having seizures or cardiac arrhythmias should be treated
in the conventional manner.

Basic Decontamination

Patients who are able may assist with
their own decontamination. Remove and double-bag contaminated
clothing and personal belongings.

Flush exposed skin and hair with water
for 3 to 5 minutes (preferably under a shower). Wash thoroughly
with soap and water, rinse thoroughly with water. Use caution
to avoid hypothermia when decontaminating children or the
elderly. Use blankets or warmers when appropriate.

Flush exposed eyes with plain water or
saline for at least 15 minutes. Remove contact lenses if easily
removable without additional trauma to the eye. Continue irrigation
while transporting the patient to the Critical Care Area.

In cases of ingestion, do not induce
emesis. Do not administer activated charcoal or attempt to
neutralize stomach contents. If it has not been given
previously, administer 4 to 8 ounces of water or milk to adults
to flush residual acid from the esophagus and to dilute stomach
contents. (Children's dose is 2 to 4 ounces.)

Critical Care Area

Be certain that appropriate decontamination
has been carried out (see Decontamination Area above).

ABC Reminders

Evaluate and support airway, breathing,
and circulation as in ABC Reminders above. Children
may be more vulnerable to corrosive agents than adults because
of the relatively smaller diameter of their airways. Establish
intravenous access in seriously ill patients if this has not
been done previously. Continuously monitor cardiac rhythm.

Patients who are comatose, hypotensive,
or have seizures or cardiac arrhythmias should be treated
in the conventional manner.

Inhalation Exposure

Administer supplemental oxygen by mask
to patients who have respiratory symptoms. Treat patients
who have bronchospasm with aerosolized bronchodilators. The
use of bronchial sensitizing agents in situations of multiple
chemical exposures may pose additional risks. Consider the
health of the myocardium before choosing which type of bronchodilator
should be administered. Cardiac sensitizing agents may be
appropriate; however, the use of cardiac sensitizing agents
after exposure to certain chemicals may pose enhanced risk
of cardiac arrhythmias (especially in the elderly). Sympathomimetic
bronchodilators generally will reverse bronchospasm in patients
exposed to hydrogen chloride.

Some authorities recommend treatment
with high doses of corticosteroids for patients who have high-dose
exposures, but the value of this treatment is questionable
and unsupported by clinical studies.

Skin Exposure

If the skin was in contact with concentrated
hydrochloric acid or hydrogen chloride gas or mists, chemical
burns may occur, treat as thermal burns.

Because of their relatively larger surface
area:body weight ratio, children are more vulnerable to toxicants
affecting the skin.

Eye Exposure

Continue irrigating for at least 15 minutes
or until the pH of the conjunctival fluid has returned to
normal. Test visual acuity. Examine eyes for corneal damage
and treat appropriately. Immediately consult an ophthalmologist
for patients who have corneal injuries.

Ingestion Exposure

Do not induce emesis. Do not administer
activated charcoal or attempt to neutralize stomach contents.
Immediate dilution with 4 to 8 ounces of water or milk may
be beneficial (pediatric dose 2 to 4 ounces) for alert patients
who can swallow.

Consider endoscopy to evaluate the extent
of gastrointestinal tract injury. Extreme throat swelling
may require endotracheal intubation or cricothyroidotomy.
Gastric lavage is useful in certain circumstances to remove
caustic material and prepare for endoscopic examination. Consider
gastric lavage with a small nasogastric tube if: (1) a large
dose has been ingested; (2) the patient's condition is evaluated
within 30 minutes; (3) the patient has oral lesions or persistent
esophageal discomfort; and (4) the lavage can be administered
within 1 hour of ingestion. Care must be taken when placing
the gastric tube because blind gastric-tube placement may
further injure the chemically damaged esophagus or stomach.

Because children do not ingest large
amounts of corrosive materials, and because of the risk of
perforation from NG intubation, lavage is discouraged in children
unless performed under endoscopic guidance.

Toxic vomitus or gastric washings should
be isolated (e.g., by attaching the lavage tube to isolated
wall suction or another closed container).

The use of corticosteroids to prevent
acid-induced strictures is questionable and unsupported by
clinical studies.

Antidotes and Other Treatments

There is no antidote for hydrogen chloride
poisoning.

Laboratory Tests

The diagnosis of acute hydrogen chloride
toxicity is primarily clinical, based on symptoms of the corrosive
action of the gas or acid. Routine laboratory studies for
all exposed patients include CBC, glucose, and electrolyte
determinations. Monitor acid-base status in patients who have
ingested hydrochloric acid. If respiratory-tract irritation
is present, monitor with chest radiography and pulse oximetry
(or ABG measurements).

There is no biologic test specific for
systemically absorbed hydrogen chloride.

Disposition and Follow-up

Patients who develop serious signs or
symptoms of hydrogen chloride exposure should be hospitalized
and observed closely for 4 to 6 hours or until asymptomatic.

Delayed Effects

Delayed effects are unlikely in patients
who have minor symptoms that resolve quickly. However, symptoms
can be delayed for 1 to 2 days.

Patient Release

Patients who have had minor exposure
and who are asymptomatic 4 to 6 hours after exposure may be
discharged and advised to seek medical care promptly if symptoms
develop (see the Hydrogen Chloride-Patient Information
Sheet below).

Follow-up

Obtain the name of the patient's primary
care physician so that the hospital can send a copy of the
ED visit to the patient's doctor.

Patients who have inhaled significant
amounts of hydrogen chloride should be monitored with pulmonary
function tests. Patients should also be monitored for the
development of Reactive Airway Dysfunction Syndrome (RADS),
a chemically- or irritant-induced type of asthma. About 2
to 4 weeks after an ingestion, consider follow-up esophagoscopy
and an upper gastrointestinal tract series to evaluate secondary
scarring or stricture formation.

Patients who have skin or corneal injury
should be re-examined within 24 hours.

Reporting

If a work-related incident has occurred,
you may be legally required to file a report; contact your
state or local health department.

Other persons may still be at risk in
the setting where this incident occurred. If the incident
occurred in the workplace, discussing it with company personnel
may prevent future incidents. If a public health risk exists,
notify your state or local health department or other responsible
public agency. When appropriate, inform patients that they
may request an evaluation of their workplace from OSHA or
NIOSH. See Appendices III and IV for a list of agencies that
may be of assistance.

Patient Information Sheet

This handout provides information and
follow-up instructions for persons who have been exposed to
hydrogen chloride.

Print this handout only. 19k

What are hydrogen chloride and hydrochloric acid?

Hydrogen chloride is a colorless to slightly
yellow gas with a sharp, irritating odor. It forms a dense
white vapor when it comes in contact with air. When hydrogen
chloride dissolves in water, it forms hydrochloric acid also
known as muriatic acid. Both hydrogen chloride and hydrochloric
acid are corrosive and may cause burns on contact. Hydrogen
chloride is not flammable.

What immediate health effects can be caused by exposure to hydrogen chloride and hydrochloric acid?

Hydrogen chloride gas can irritate the
lungs, causing a cough and shortness of breath. Breathing
high levels of the gas or vapor can lead to a build-up of
fluid in the lungs, which may cause death. Because hydrochloric
acid is corrosive, it can cause eye damage, even blindness,
if splashed in the eyes. Skin contact can cause severe burns.
Ingestion of concentrated hydrochloric acid can cause severe
injury to the mouth, throat, esophagus and stomach. Generally,
the more serious the exposure, the more severe the symptoms.

Can hydrogen chloride and hydrochloric acid poisoning be treated?

There is no antidote for poisoning due
to these substances, but their effects can be treated and
most exposed persons get well. People who have had serious
exposures may need to be hospitalized.

Are any future health effects likely to occur?

A single, small exposure from which a
person recovers quickly is not likely to cause delayed or
long-term effects. Patients who breath a large amount of hydrogen
chloride may develop permanent lung injury. If hydrochloric
acid was swallowed, a patient may permanently have trouble
swallowing.

What tests can be done if a person has been exposed to hydrogen chloride and hydrochloric acid?

Specific tests for the presence of hydrogen
chloride in blood or urine generally are not useful to the
doctor. If a severe exposure has occurred, blood and urine
analyses and other tests may show whether the lungs or stomach
has been injured. Testing is not needed in every case.

Where can more information about hydrogen chloride and hydrochloric acid be found?

More information about hydrogen chloride
and hydrochloric acid can be obtained from your regional poison
control center; your state, county, or local health department;
the Agency for Toxic Substances and Disease Registry (ATSDR);
your doctor; or a clinic in your area that specializes in
occupational and environmental health. If the exposure happened
at work, you may wish to discuss it with your employer, the
Occupational Safety and Health Administration (OSHA), or the
National Institute for Occupational Safety and Health (NIOSH).
Ask the person who gave you this form for help in locating
these telephone numbers.

ATSDR can also tell you the location of occupational and environmental health clinics. These clinics specialize in
recognizing, evaluating, and treating illnesses resulting from exposure to hazardous substances.

Information line and technical assistance:
Phone: 888-422-8737

To order toxicological profiles, contact:
National Technical Information Service
5285 Port Royal Road
Springfield, VA 22161
Phone: 800-553-6847 or 703-605-6000

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The information contained here was correct at the time of publication. Please check with the appropriate agency for any changes to the regulations or guidelines cited.